Bartholin gland carcinoma is a type of cancer of the vulva arising in the

Bartholin gland The Bartholin's glands (named after Caspar Bartholin the Younger; also called Bartholin glands or greater vestibular glands) are two pea sized compound alveolar glandsManual of Obstetrics. (3rd ed.). Elsevier. pp. 1-16. . located slightly poster ...

. It typically presents with a painless mass at one side of the vaginal opening in a female of middle-age and older, and can appear similar to a Bartholin cyst. The mass may be big or small, may be deep under skin or appear nearer the surface with overlying

ulceration An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...

. Average age at presentation is 53-years. The

tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

can become large before a woman is aware of

symptom Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...

s. One of the first symptoms can be painful sex. In other instances there may be a mass or ulcer in the vulva area. Many clinicians assume that an enlarged Bartholin gland is malignant in postmenopausal woman until proven otherwise. The growth of the tumor can spread to nearby areas such as the

ischiorectal fossa The ischioanal fossa (formerly called ischiorectal fossa) is the fat-filled wedge-shaped space located lateral to the anal canal and inferior to the pelvic diaphragm. It is somewhat prismatic in shape, with its base directed to the surface of the ...

and

inguinal lymph nodes Inguinal lymph nodes are lymph nodes in the human groin. Located in the femoral triangle of the inguinal region, they are grouped into superficial and deep lymph nodes. The superficial have three divisions: the superomedial, superolateral, and inf ...

. Approximately 50% of bartholin gland carcinomas originate from squamous cell carcinomas. Another uncommon characteristic of Bartholin gland malignancies is that the growth of a lesion originates from the three types of epithelial tissue present in the gland:

mucinous Mucus ( ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both serous and mucous cells. It i ...

, transitional, and

squamous Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellula ...

. It is rare, accounts for less then 1% of all female genital tract cancer and less than 5% of all

vulva cancer Vulvar cancer is a cancer of the vulva, the outer portion of the female genitals. It most commonly affects the labia majora. Less often, the labia minora, clitoris, or vaginal glands are affected. Symptoms include a lump, itchiness, changes in t ...

Cause

The cause is unknown.

Diagnosis

Bartholin gland can be differentiated by histology to determine whether the malignancy is due to squamous cell carcinoma, adenoid cystic carcinoma, or adenocarcinomas.

Management

Though Bartholin gland carcinoma is rare, along with other unusual Bartholin gland growths, it many not be the typical practice for clinicians to consider lesions malignant. Early diagnosis can help to prevent the cancer from the glands to surrounding. Though malignancies of the Bartholin gland are rare clinicians biopsy Bartholin gland lesions in older women or when the growth reoccurs or does not respond to original treatment.

Prognosis

The prognosis is optimistic as long as the growth has not metastasized to the lymph nodes.

History

Bartholin glands were described in cattle by Casper Barthlin in 1677. Their existence in humans was postulated at that time. Treatment can be a

vulvectomy Vulvectomy refers to a gynecological procedure in which the vulva is partly or completely removed. The procedure is usually performed as a last resort in certain cases of cancer, vulvar dysplasia, vulvar intraepithelial neoplasia, or as part o ...

that results in the removal of the growth along with an extensive removal of adjacent tissue. An inguinal lymphadenectomy often accompanies the vulvectomy. The tissue that is removed sometimes includes sections of the

vagina In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...

and

rectum The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...

.Clinical gynecologic oncology, Philip DiSaia, editor. Chapter 8, Invasive Cancer of the Vulva, Jeanne M. Schilder, and Frederick B. Stehman. Pages 219-244. Elsevier/Saunders.(2012). ; Access provided by the

University of Pittsburgh The University of Pittsburgh (Pitt) is a public state-related research university in Pittsburgh, Pennsylvania. The university is composed of 17 undergraduate and graduate schools and colleges at its urban Pittsburgh campus, home to the universit ...

. The

Adenoid cystic carcinoma Adenoid cystic carcinoma is a rare type of cancer that can exist in many different body sites. This tumor most often occurs in the salivary glands, but it can also be found in many anatomic sites, including the breast, lacrimal gland, lung, brai ...

of the Bartholin gland is another uncommon malignancy with symptoms that include local painful intermittent recurrences. The disease is slow to progress but it can result in lung cancer after a long time after the initial treatment. Treatment consists of surgical removal of the growth. Sometimes radiation and chemotherapy is performed.Clinical gynecologic oncology, Phillip Saia, editor. Chapter 8, Invasive Cancer of the Vulva, Jeanne M. Schilder, and Frederick B. Stehman. Pages 219-244. Elsevier/Saunders.(2012). ; Access provided by the

References

External links

Gynecologic Oncology Group
an NIH-Funded research group that runs clinical trials
CancerNet
an NIH database with clinical and scientific information
PubMed
a search engine and database for Medical Literature {{Female genital neoplasia, state=collapsed Rare cancers Gynaecological cancer Gynaecology Gynaecological neoplasia Women's health Oncology